Answer to “Coffee” in the Morning? Go see the Doctor
Correct answer is E, the 1st part of the duodenum. Note, an anterior view of the intact abdomen with the greater omentum reflected is shown on the image on the left. On the right, the posterior view of an isolated abdomen is presented. Coffee ground emesis (or vomitus) is vomit that looks like coffee grounds. It's dark brown or black in color with a lumpy texture. The appearance comes from old and coagulated blood in the gastrointestinal tract, a sign of internal bleeding. The abdominal pain and nausea may have been associated with a peptic ulcer. The location indicated in the image, the 1st part of the duodenum, is generally where peptic ulcers appear. Internal bleeding from the transverse colon is much more likely to end up in the stool. A ruptured spleen would be associated with significant pain in the upper, left back and bleeding would have been internal. Pain from gall bladder is generally to the upper, right quadrant. Referred pain from the pancreas is to the back, but the patient would likely be described as jaundiced if the pathology were to be present at the head of the pancreas.
= Transverse colon
= Spleen
= Head of pancreas
= Gall bladder
= 1st part of duodenum
Answer to this question is based on material presented in lectures 7 of the Abdomen Lecture Series.
